This invention relates to an ultrasonic surgical aspiration system. More particularly, this invention relates to an improved irrigation/aspiration manifold and associated parts for such an ultrasonic surgical aspiration system. Still more particularly, this invention relates to the use of mating connections in such a system to allow easy, rapid, and foolproof connections to the irrigation, aspiration, and tissue relief ports in an ultrasonic surgical aspiration system. In addition, this invention relates to an improved transition member which allows an easy exchange of flues, articulation without leakage, and a swivel joint which permits use of curved ultrasonic members in an ultrasonic surgical aspiration system.
Ultrasonic surgical devices are known for performing a number of surgical procedures. A representative device is shown in U.S. Pat. No. 3,589,363 describing a hand-held instrument having an operative tip vibrating at a frequency in the ultrasonic range, and in which a handpiece includes a transducer. Connections are provided on the handpiece to a source of treatment fluid and to a pump to withdraw suspended tissue particles in a fluid from an operative site.
The design of such ultrasonic surgical devices has depended not only on the technical and functional requirements of a resonant body, but also upon their surgical application. Thus, the parameters of the system, the length of the tip, and the tip stroke and diameter to be acceptable for a useful surgical device in various operative site areas have developed over the years, based upon experience with such devices. Attention has been paid in the art to the development of the various components in the system, with the result that an ultrasonic surgical aspiration instrument is well-known and used as a sophisticated hightechnology surgical instrument.
Such a system has been developed and produced by the assignee of this invention which comprises an assembly of an acoustic vibrator, a nosecone, a flue, a handpiece and a manifold. The assembled system provides a source of irrigation fluid to an operative site and the aspiration of surgically-excised particles from the site under the control of precise and sophisticated instrumentation. A number of modifications to such a basic system have been made with respect to such items as the length and shape of the tip, its coupling with a transducer, the use of an extender (whether curved or straight), and others. Usually, the components for a surgical use are provided as a part of a sterile surgical kit to be used and discarded after each surgical procedure.
The acoustic vibrator assembly includes the combination of a transducer connected to a handpiece for providing a source of ultrasonic vibrations to a tip. When the tip is connected to the transducer, or to a straight or curved extender interposed between the tip and the transducer, provisions are made in the kit for connecting the components to a predetermined level of tightness. A nosecone assembly is then assembled from a nosecone which is provided with O-ring seals in grooves in the nosecone and slid over the acoustic vibrator until seated. A flue is slid over the tip and hand tightened to the nosecone to provide a passage within the flue and about the length of the tip for irrigation fluid from the nosecone to the tip. A nosecone adapter may be used with an extender flue to provide alternative length and shapes for the convenience of the surgeon and safety for the patient for particular operations. When used, the nosecone adapter is tightened to the nosecone and the extender flue is gently pushed over the tip of the nosecone so that the curve of the extender and flue match without the flue touching the tip. The body of the flue adapter is twisted to centralize the tip within the flue. Thereafter, the acoustic vibrator and the nosecone with the flue attached are inserted into a handpiece housing and seated so that the fluid manifold assembly may be completed.
An irrigation tube with a flexible applicator cable is fed through a slot in the nosecone and through an aspiration port on the exterior of the tip. By gently pulling the cable through the port in the tip, the aspiration tubing attaches to the aspiration port on the tip. The other end of the aspiration tubing is connected about a pump to control aspiration pressures and to a discard region for discarding extracted tissue. Metallic clips are provided to secure the aspiration tubing to the exterior of the handpiece housing. Thereafter, irrigation tubing is connected to the irrigation port on the nosecone for connection at its other end to a source of irrigation fluid, such as an IV bottle. Additional clips are provided to the handpiece cable to secure the manifold.
Thus, the assembled system is able to provide irrigation fluid from an irrigation fluid source through tubing to an irrigation port and through the nosecone into the area intermediate the tip and the flue to irrigate the surgical site adjacent the tip extending from the flue. Aspiration occurs from the operative site through an aspiration passage to the aspiration port and through the aspiration tubing to aspirate surgically-excised particles.
As can be seen from the above simplified description, several fluid connections must be made at the surgical handpiece and elsewhere to provide irrigation to and aspiration from the surgical site. While such prior designs were satisfactory, they utilized plain tubing ends which require skilled and special application techniques for making the connections. In addition, the assembly procedure was further complicated by the number of tips and extended options available to the surgeon. It thus remained a problem in the art to assure easy, rapid and foolproof connection of the irrigation, aspiration and tissue release ports to the correct tubing and location, since such connections are made in an operating room in preparation for surgery or during the surgical procedure itself in certain situations where modification or reconnection is needed.
Thus, it is a main objective of this invention to provide a mating component system for an ultrasonic surgical vibrator which uses quick-connecting devices to facilitate connection of the components and tubing to the irrigation, aspiration and tissue release ports.
It is another object of this invention to provide an improved transition piece to permit an easy exchange of flues between a rigid flue and a ribbed flexible flue for easy connection to an assembly of a handle, nosecone, and tip.
It is an additional object of this invention to provide a nosecone extension which provides a rotating joint for assembly to a nosecone and an articulating joint for connection to either a rigid flue secured with or without an O-ring or to a ribbed flexible flue.
It is a further object of this invention to provide a ribbed flexible flue structure for convenient use with an ultrasonic surgical aspiration system of the type described.
It is a further object of this invention to provide a nosecone extension adapter for ready connection to an extender connected to an assembly of a handle, nosecone, and vibrator for receiving therein an extended tip and an extender sheath which is connected to the nosecone extension adapter for connection between the extender sheath and a flue adapter having an articulating joint for receiving either a ribbed flexible flue or a rigid flue as described.
It is an additional object of this invention to provide an aspiration tubulation connector for secure connection to an aspiration tube and quick, secure connection with limited motion to the aspiration port on the tip within a confined space in the interior of the handpiece.
It is a further object of this invention to provide a quick connect fitting for connection between an end of the irrigation tube and the irrigation tube fitting by turning and locking, and easy connection to an irrigation port on a transition member or nosecone extender.
It is a more general object of this invention to provide an ultrasonic surgical aspiration system with conveniently-usable components capable of easy assembly in diverse combinations while minimizing error in the assembly, which components are adapted for easy fluid connection.
These and other objects of the invention will become apparent from the written description of the invention which follows.